HomeMy WebLinkAboutPermit Mechanical 1994-10-24
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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JOB NUMBER .:::9q/~~ /
225 Fifth Street
Springfield, Oregon 97477
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ASSESSORS MAP'
LOCATION OF PROPOSED WORK'
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CITY'
BLOCK:
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STATIO. '
SUBDIVISION'
PHONE:
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ZIP:_CJ 7y/"'!
DESCRIBE WORK'
NEW REMODEL
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ADDITION DEMOLISH OTHER
CONTRACTOR'S NAME (
GENERA" . :Jp_s.;..J? <;
PLUMBING'
MECHANICAl' .X
ELECTRICAl'
ADDRESS
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_ CONST.
hltS ""a.,1V CONTRACTOR'
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EXPIRES PHONE
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- OFFICE USE -
QUAD AREA' LAND USF' FLOOD PLAIN:
· OF BLDGS' . OF UNITS' ZONING CODE: _
OCCY GROUP: CONSTA. TYPE: . OF BDRMS'
· OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requested before 7:00 a,m. will be
made the same working day. Inspections requested after 7:00 a.m. will be made the following work day.
D Temporary Electric
D Site Inspection - To be made
after excavation. but prIor to
setting forms.
D Underalab Plumbing/Electrical/
'Mechanical - Prior to cover.
D Footing - After ,trenches are
excavated. ...
D Maaonry - Steel, location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumblng/Mechanlcat
- Prior to Insulation or decking.
D Poat and Beam - Prior to floor
Inaulatlon or decking. '
D Floor Insulation - Prior to
deckl ng.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
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REQUIRED INSPECTIONS
D Rough Mechanical -..:. Prior to
cover.
o Rough -ElectrIcal - Prior to
cover.
D Electrical Service - Must be
approved to obtai n permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior. to cover.
I
o Wail/Ceiling InsJlatlon - Prior to
cover.
D Drywall - Prior to taping.,
D Wood Slovo - After Installation.
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
D Fence - When completed.
D Street Trees - When all required
trees are planted. .
D Final Plumbing - When all
plumbing w9rk Is complel,e.
o Final Electrical - \^/.hen all
electrical work Is complete. C
rt7I FInal Mechanical - When all
lC-l mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
D Blocking and Sel-Up - Whep all
blocking Is complete.
D Plumbing Connections - When
home has been connected to .
waler and sewer.
D Electrical Connecllon - When
blocking, set-up, and plun;)blng
Inspections have been approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot Type.
Lot sq. ftg.
Interior
Lot coverago
Corner
Topography
Totaf ~elght
Panhandle
Cul.de.sac
Setbacks
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IN
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BUILDING PERMIT
ITEM sa. FT. x $ISO. FT. _ VALUE
/.lain
Gacage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
.
Residential Bath(s) N'
Sanitary Sewer FT.
. Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace ~;5
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
4~ <~'?'P-?
Mechanical Permit ~Fff
Issuahce
State :Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
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FEE
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_S THE PROPOSED WORK,tN THE. '
mHISTOl;1lCAL DISTRICT, OR ON
"THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City, of Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or ,revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on th's
project.
I further agree to ensure that all required Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the site at all times du construction.
Signature n J) ~
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VALIDATION:
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AMOUNT RECEIVED -?6.;;!?O
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RECEIPT NUMBER
DATE PAIr'
RECEIVED BY
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